| NPI | 1548641806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: CO 068245) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL38473) |
| 207R00000X Internal Medicine (Licence: OH 35.133628) | |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2022-05-27 |